New Ottawa-area health unit includes large swath of eastern Ontario

Ottawa Public Health (OPH) would become part of a significantly larger health unit region that includes municipalities as far away as Kingston under the Ontario Progressive Conservatives’ plan to merge public health agencies across the province.

Coun. Keith Egli, chairman of the OPH board, said the agency learned from the provincial government on Monday how broad the new health unit would be.

Egli said the information relayed by the province suggests Ottawa’s region would include the areas of Prescott-Russell, Stormont, Dundas and Glengarry, Renfrew, Lanark, Leeds and Grenville, Lennox and Addington, Frontenac, Kingston and Cornwall.

According to Egli, the province provided few other details about the merger, which is reducing the existing 35 public health units in Ontario to 10 units.

Egli said there was no information about how the governance structure would work, where the so-called Region 7 health unit would be headquartered or how the staffing would be decided.

All Egli said he knew was that the new health unit would include more than 1.6 million people and cover almost 29,000 square kilometres.

“That’s a huge jump for Ottawa,” Egli said, adding that the province has vowed to consult on the proposed mergers.

“I certainly hope that’s true because the changes would be significant.”

The new health-unit structure comes as the PCs also change the funding structure for public health agencies. While the province has paid 75 per cent of local public health programs, the rate is slated to dip to 60 per cent in the next three years. The rest of the money in local health unit budgets comes mostly from property taxpayers.

“More people, more geography, less money,” Egli said.

OPH was working on a message to its staff about the proposed merger. There are so few details about how the merger would work that it’s hard for managers to explain with any certainty how the move will impact staffing, especially when there could be multiple unions affected across the health units.

“I want them to know that we’re going to do everything we can do keep public health in Ottawa has whole as we can,” Egli said of OPH’s staff.

In an email Monday evening, a spokeswoman for Health Minister Christine Elliott said no final decision has been made on the new regional health units’ boundaries.

“While the government will bring forward proposals, the specific boundaries of the new regional health units will be finalized in consultation with municipalities through technical working groups, which we expect to launch shortly,” said Elliott’s press secretary Hayley Chazan. “Through these technical working groups, we will also work with our municipal partners to design governance and delivery models that protect and preserve the voice of all municipalities. In doing so, we will ensure that public health investments better meet the needs of local communities.”

The province plans to modernize and streamline the public health units to “better coordinate” health promotion and disease prevention programs, she said.

“Ultimately, the government’s proposed plan will enable a better matching of public health needs with local realities.”

Frontenac Islands Mayor Denis Doyle, the chairman of the Kingston, Frontenac and Lennox and Addington Public Health board, said he heard the province was considering two options for that health unit, including the one that lumped it in with the City of Ottawa’s “big operation.”

Doyle said his health unit’s fear is that it will get lost in a larger public health agency.

“We’ll be a satellite office to Ottawa,” Doyle said, noting that his community has been happy with the work of the local health unit.

Like his Ottawa counterpart, Doyle said he has several questions about how the province would execute the mergers, especially when it comes to governance.

There are so many municipalities in the proposed health unit region that it could make representation on a board of health difficult, unless the board has dozens of representatives. There’s also speculation that there could be provincial appointments to health boards.

“We have representation from those who pay the bill,” Doyle said, adding that it would be undemocratic to not have fair representation from all municipalities in the health unit.

Another concern shared by OPH and surrounding health units is the fate of community-specific health programs.

In Ottawa, Egli said OPH aims to make programming available in both official languages and has been working closely with Indigenous and refugee groups.

“Ottawa, like other cities, has some unique challenges,” Egli said.

With the health unit mergers planned to happen over the next year, Egli said OPH will need much more information from the province to understand how a consequential governance and service change will happen so quickly.